2013-2018年甘肃省妇幼保健院临床检出病原菌及耐药性分析

Clinical isolates of pathogens isolated from Matenity and Child-care Hospital from 2013 to 2018 and drug resistance

目的了解甘肃省妇幼保健院检出病原菌种类分布及耐药情况,为临床合理使用抗菌药物提供科学依据。方法选择甘肃省妇幼保健院2013年1月-2018年12月临床送检病原学标本47028份,通过医院感染实时监控管理系统、临床微生物检验系统,对分离病原菌种类及耐药率进行回顾性分析。结果2013-2018年共收集非重复菌株13638株,主要病原菌种类包括大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、屎肠球菌和铜绿假单胞菌,分离率分别为32.20%、18.32%、13.14%、4.27%、6.52%;肺炎克雷伯菌对碳青霉烯类药物的耐药率逐年上升,2018年高于全国平均水平;未发现耐万古霉素和利奈唑胺金黄色葡萄球菌菌株;屎肠球菌近6年的耐药率整体较高,多药耐药整体防控形势严峻。结论该院2013-2018年细菌耐药性呈增高趋势,多药耐药菌检出率亦升高明显,应加强细菌耐药监测和规范抗菌药物的合理应用。

OBJECTIVE To investigate the distribution of clinical pathogens and the changes of drug resistance in the Maternity and Child-care Hospita of Gansu Province,so to provide scientific basis for the rational use of antibacterial drugs in clinical practice.METHODS A total of 47028 pathogenic specimens submitted for clinical examination were selected from Jan.2013 to Dec.2018 in Gansu Maternal and Child Health Hospital.Retrospective analysis was performed on the types and resistance rates of isolated pathogens through the real-time hospital infection management system and clinical microbiology testing system.RESULTS A total of 13638 non-duplicate clinical strains were collected during 2013-2018.The main pathogens included Escherichia coli,Klebsiella pneumonia,Staphylococcus aureus,Entero-coccus and Acianetobactor baumannii with the isolation rates of 32.90%,18.32%,13.14%,4.27%and 6.52%,respectively.The resistance rate of K.pneumoniae to carbapenems has been increasing year by year,higher than the national average in 2018.No vancomycin and linezolid resistant S.aureus strains were found.The overall resistance rate of E.faecium in the past 6 years was relatively high,and the overall prevention and control of multidrug resistance was severe.CONCLUSION Bacterial resistance in this hospital from 2013 to 2018 takes on a rising trend.The detection rate of multidrug-resistant bacteria also increased significantly.The monitoring of bacterial resistance and the rational application of antibacterial drugs should be strengthened.